Changfa Guo, MD, Husnain Kh. Haider, PhD, Winston S. N

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Myoblast-based cardiac repair: Xenomyoblast versus allomyoblast transplantation  Changfa Guo, MD, Husnain Kh. Haider, PhD, Winston S.N. Shim, PhD, Ru-San Tan, MBBS, Lei Ye, MD, PhD, Shujia Jiang, MD, Peter K. Law, PhD, Philip Wong, MBBS, Eugene K.W. Sim, FRCS  The Journal of Thoracic and Cardiovascular Surgery  Volume 134, Issue 5, Pages 1332-1339.e2 (November 2007) DOI: 10.1016/j.jtcvs.2007.07.025 Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Immunostaining and observation of time of infiltration of macrophages (A and B), CD8+ cells (C and D), and CD4+ cells (E and F) into the cell injection site (magnification ×400). *Significantly increased numbers of infiltrating cells (including macrophages, CD4+ cells, and CD8+ cells) compared with those of groups 1 or 2 (groups 3 and 5 vs group 1; groups 4 and 6 vs group 2, P < .01). #After cyclosporine treatment, the infiltrating cells (including macrophages, CD4+ cells, and CD8+ cells) significantly decreased compared with those in the groups not receiving cyclosporine treatment (group 4 vs group 3 and group 6 vs group 5, P < .01). The Journal of Thoracic and Cardiovascular Surgery 2007 134, 1332-1339.e2DOI: (10.1016/j.jtcvs.2007.07.025) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Echocardiographic analysis showed improved heart function after skeletal myoblast transplantation. There was no significant difference in baseline heart performance (ejection fraction [EF] and fractional shortening [FS]) among the different groups of animals. Within groups, significant improvement in EF and FS was observed after skeletal myoblast transplantation (groups 3–6) compared with baseline values (P < .01), whereas there was no functional improvement in the DMEM-treated groups (groups 1 and 2). Between-group analyses: *Significant improvement of EF/FS compared with that seen in control group 1 (comparison among groups not receiving cyclosporine treatment). †Significant improvement of EF/FS compared with control group 2 (comparison among cyclosporine-treated groups, P < .01). In the EF arm (A), with cyclosporine treatment, EF increased to a significant level compared with that seen in the groups not receiving cyclosporine treatment (group 4 vs group 3 and group 6 vs group 5, P < .05). No significant improvement was observed in allogeneic groups compared with that of xenogeneic groups (group 5 vs group 3 and group 6 vs group 4). In the FS arm (B) no significant difference was observed in the skeletal myoblast transplantation groups (groups 3-6) after cell therapy. The Journal of Thoracic and Cardiovascular Surgery 2007 134, 1332-1339.e2DOI: (10.1016/j.jtcvs.2007.07.025) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 Immunostaining and flow cytometric assay of skeletal myoblasts for desmin and 4′,6′-diamidino-2-phenylindole hydrochloride and lac-z labeling efficiency. A1, Green fluorescent cytoplasm showing desmin-positive skeletal myoblasts. A2, Human skeletal myoblasts were 98.89% pure (blue curve) for desmin expression when gated for control at 1.02% (red curve) by means of flow cytometric assay. B1, Desmin-positive rat skeletal myoblasts. B2, Rat skeletal myoblasts were 75.35% pure (blue) for desmin expression when gated for control at 1.02% (red) by means of flow cytometric assay. C1, 4′,6′-Diamidino-2-phenylindole hydrochloride–labeled skeletal myoblasts (blue nuclei). C2, Merged image of panel C1 and phase-contrast image to show total number of cells. D, Lac-z–positive cells with green nuclei. (Original magnification: 200×). The Journal of Thoracic and Cardiovascular Surgery 2007 134, 1332-1339.e2DOI: (10.1016/j.jtcvs.2007.07.025) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

Figure E2 Myoblast survival and differentiation after transplantation. A, 4′,6′-Diamidino-2-phenylindole hydrochloride–labeled skeletal myoblasts 7 days after transplantation. Note the presence of cells at the injection site without orientation. B, 4′,6′-Diamidino-2-phenylindole hydrochloride–labeled skeletal myoblasts 28 days after transplantation showed typically aligned orientation, which followed host muscle architecture. C, Hematoxylin and eosin staining to show the myocardium of continuous section from panel B. D, Myosin heavy chain (slow isoform) immunostaining counterstained with hematoxylin to show myoblast differentiation and (E). F, Myosin heavy chain (fast isoform) immunostaining counterstained with hematoxylin. G, Myoblast survival confirmed by lac-z staining (green nuclei) counterstained with hematoxylin. (Original magnifications: A-D, 100×; E-F, 800×; G, 400×). The Journal of Thoracic and Cardiovascular Surgery 2007 134, 1332-1339.e2DOI: (10.1016/j.jtcvs.2007.07.025) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions